Modified Frailty Index Independently Predicts Postoperative Pulmonary Infection in Elderly Patients Undergoing Radical Gastrectomy for Gastric Cancer

Abstract

Background Pulmonary infection is one of the most common postoperative complications after radical gastrectomy for gastric cancer (GC) and is associated with a poorer prognosis. This study aimed to investigate potential predictive factors for pulmonary infection in elderly GC patients. Methods This study retrospectively enrolled 346 elderly GC patients undergoing elective radical gastrectomy between January 2017 and December 2020. Pulmonary infection within postoperative 30 days was set as the primary observational endpoint. The baseline demographic, clinicopathological, and laboratory data were compared between patients with or without pulmonary infection. ROC curves were plotted to evaluate the cut-off and predictive values of factors. Binary univariate and multivariate logistic regression analyses were employed to determine risk factors for postoperative pulmonary infection. Results Of the enrolled 346 patients, pulmonary infection was observed in 51 patients within postoperative 30 days, with an incidence of 14.7%. mFI was a significant predictor for pulmonary infection by ROC curve analysis (AUC: 0.770, P < 0.001). Moreover, preoperative mFI was the only independent risk factor for pulmonary infection (OR: 2.72, 95% CI: 2.02–3.31, P = 0.011) by univariate and multivariate logistic regression analyses. Conclusion Our study indicates that mFI independently predicts pulmonary infection in elderly GC patients.

The 5-factor modified Frailty Index (mFI-5) predicts adverse outcomes after elective Anterior Lumbar Interbody Fusion (ALIF)

“…However, they analyzed the odds of developing pulmonary complications collectively, whereas our analysis focused on specific complications. Additionally, mFI-5 scores have been shown to be predictive of pulmonary complications following other non-orthopaedic procedures as well [ 29 , 30 ].…”

“…Furthermore, the association of mFI-5 scores with risk of UTI and pneumonia may be explained by diabetes mellitus being a component of the index. Diabetes has been shown to increase the risk of infections through various physiologic mechanisms [29] .…”

Impact of frailty on survival and readmission in patients with gastric cancer undergoing gastrectomy: A meta-analysis

“…Apart from the abovementioned outcomes, frailty, as defined by the Modified Frailty Index, was an independent predictor of non-home discharge ( 26 ) and postoperative pulmonary infection ( 27 ) in elderly patients with gastric cancer who underwent gastrectomy. In patients with gastric cancer above the age of 80 years, frailty independently predicted the recurrence-free survival ( 13 ).…”

Usefulness of the Modified Frailty Index for Predicting Pneumonia Occurrence After Esophagectomy

“…Pneumonia was diagnosed by the presence of new or progressive infiltrates on chest radiographs and bacterial sputum cultures, with two or more of the following: antibiotic treatment, temperature > 38°C, leukocytosis (leukocyte count > 12 × 10 3 /µL) or leukopenia (leukocyte count < 4 × 10 3 /µL), and purulent secretions. 14 Pneumonia found incidentally during CT for other reasons was also included. All of the aforementioned complications were considered within 30 days of surgery or hospitalization, whichever was longer.…”

“…Recently, there have been scattered reports examining the correlation between the mFI and surgical outcomes. [11][12][13][14] Therefore, in this study, we investigated whether the mFI can be used to determine the postoperative complications of esophagectomy.…”